Contract Case Reviewer Jobs in Georgia (NOW HIRING)

Benefits:

• 401(k)
• 401(k) matching
• Competitive salary
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

About the Role:

This position is contingent upon contract award. Normal hours are 0800 to 1600 (EST) Monday through Friday excluding Federal Holidays. Core hours (must be present) are 0900 to 1500 (EST). Flex time is permitted to meet workload requirements.

H&H Continuous Improvement & Services is looking for an experienced Medical Case Manager Lead to be the senior small team lead over 3 other Medical Case Managers at Robins Air Force Base, GA. If you're passionate about supporting our military and ensuring that our military members are mission ready, we want to hear from you!

Responsibilities:

• Adhere to clinical standards, published regulations, and program requirements.
• Ensure packages are complete and entered accurately into required electronic systems for the aeromedical waivers, physical standards waivers, and operational and deployed member cases assigned to you. Assist team members as needed and collaborate to ensure deadlines are met and the team succeeds.
• Collaborate with units, military treatment facilities (MTF), and military and civilian healthcare providers to facilitate evaluations as required.
• Follow prescribed case management workflows, productivity metrics, and quality improvement initiatives for your team.
• Actively participate in regular case reviews and audits to ensure compliance with regulatory and contractual requirements for your team and make adjustments or corrections as needed.
• Serve as a liaison between service members and units as required.
• Actively participate in training, performance evaluations, and professional development guidance provided by Medical Case Management leadership.

Requirements:

• Active RN, LCSW, or equivalent clinical license in good standing.
• Minimum of 1 year of experience for Medical Case Manager and 1-3 years for Medical Case Manager Senior with medical case management experience preferably at an MTF.
• Certification in Case Management (CCM) preferred or working toward certification.
• Must be capable of working independently with minimal supervision and possess strong time-management and prioritization skills.
• Must be proficient in reading, writing, speaking, and understanding the English language to effectively communicate applicable technical subject matter to management, providers, and service members.
• Must possess exceptional customer service skills.
• Must possess demonstrated experience processing and managing physical exams and medical standards in military medical environments or through equivalent civilian aeromedical, occupational health, or disability evaluation system environments.
• Must demonstrate proficiency with or possess the ability to rapidly acquire proficiency in Air Force and DoD medical systems, including the Aeromedical Information Management Waiver Tracking System (AIMWTS), Physical Examination Processing Program (PEPP), Periodic Health Assessment (PHA) programs, Joint Legacy Viewer (JLV), and Management Internal Control Toolset (MICT). Familiarity with these systems and the aeromedical waiver process is a differentiator.
• Must demonstrate strong knowledge or rapidly master these requirements within 30 days of hiring regarding medical standards for retention, flying classes, Line of Duty (LOD) determinations, and special operational duty for the USAF.
• Must be familiar with or proficient in utilizing the Aeromedical Waiver Guide (AMWG) and the Medical Standards Directory (MSD) or rapidly master these requirements within 30 days of hiring.
• Must possess basic knowledge of anatomy, physiology, disorders of human body systems, and emergency medical care procedures. Must possess knowledge of medical terminology and International Classification of Diseases (ICD-10) coding and possess the ability to use medical terminology accurately when documenting cases.
• Must possess excellent oral and written communication skills and project management experience (self-managing medical cases from intake to resolution/discharge).
• Must possess the ability to translate and communicate complex medical/administrative instructions to service members at the member’s comprehension level.
• Must be proficient with Adobe and highly proficient with the Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint).
• Must possess proficient typing skills utilizing standard English keyboards with 10-key pads.

About Us:

H&H Continuous Improvement & Services is a management consulting and performance auditing firm that enhances our clients’ operational performance and customer satisfaction by focusing on customer service excellence and quality at the source. We focus on service excellence and quality by building high performing teams that embrace continuous improvement and learning. Our team members support each other and work together to accomplish each task to meet or exceed our client’s expectations.